Provider Demographics
NPI:1740203587
Name:PERKINS, FREDERICK M (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:M
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:215 NORTH MAIN STREET
Mailing Address - Street 2:VAMC & ROC #112
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05009
Mailing Address - Country:US
Mailing Address - Phone:802-295-9363
Mailing Address - Fax:802-291-6262
Practice Address - Street 1:215 NORTH MAIN STREET
Practice Address - Street 2:VAMC & ROC #112
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:802-291-6262
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0006522207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTB85657Medicare UPIN